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Surgical treatment of late developmental displacement of the hip

RESULTS AFTER 33 YEARS

St John of God Hospital, Geelong, Box 1087, Victoria 3220, Australia.

G. Fujii, MD, Consultant Orthopaedic Surgeon

Sendai National Hospital, Miyagino 2-8-8, Miyagino-Ku, Miyagi 983-8520, Japan.

E. Pickvance, MD, Staff Orthopaedic Surgeon

Cumbria Farm, 9362 McCain Road, Shreveport, Louisiana 71107, USA.

A. M. Wainwright, FRCS (Tr & Orth), Consultant Orthopaedic Surgeon; and M. K. D. Benson, FRCS, Consultant Orthopaedic Surgeon

Nuffield Orthopaedic Centre, Windmill Road, Oxford OX3 7LD, UK.

Correspondence should be sent to Mr A. M. Wainwright; e-mail: wainwright{at}noc.anglox.nhs.uk

The outcome of displaced hips treated by Somerville and Scott’s method was assessed after more than 25 years. A total of 147 patients (191 displaced hips) was reviewed which represented an overall follow-up of 65.6%. The median age at the index operation was two years. During the first five years, 25 (13%) hips showed signs of avascular change.

The late development of valgus angulation of the neck, after ten years, was seen in 69 (36%) hips. Further operations were frequently necessary. Moderate to severe osteoarthritis developed at a young age in 40% of the hips. Total hip replacement or arthrodesis was necessary in 27 (14%) hips at a mean age of 36.5 years. Risk factors identified were high dislocation, open reduction, and age at the original operation. Two groups of patients were compared according to outcome. All the radiographic indices were different between the two groups after ten years, but most were similar before. It takes a generation to establish the prognosis, although some early indicators may help to predict outcome.

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